Application Form

INSTRUCTIONS: The following online application will take approximately 45-90 minutes depending on the detail of your answers. Please look through the application before attempting it so that you will have any necessary information available. Be sure to download the forms, sign them electronically and upload them to the bottom of this form. You will also need an updated photo of yourself for application identification. If you do not already have a passport, please begin the process of obtaining one as soon as possible. Be sure to take the online love language test and Spiritual Gifts test and save the results before attempting this application.

If you would rather fill out an application by hand, please disregard this form and download/upload at the bottom of the page.

Click here for Trip Info. The cost of a two week journey to Kenya is approximately $3,500. This cost covers international airfare, transportation, lodging, meals, 1 cultural event, program costs and training. Upon receipt of acceptance letter, a $350 non-refundable deposit must be submitted towards entire payment.

Please allow up to 3 weeks for review of application!

Personal Information

Name *

First

Last

Address *

Line 1

Line 2

City

State

Zip Code

Country

Marital Status *

Single/ Never MarriedMarriedDivorced

Gender *

MaleFemale

Phone Number *

Date of Birth *

Email *

Occupation *

Languages Spoken *

EnglishKi SwahiliLuo

CPR/First Aid Certified *

YesNo

Social Security Number *

Driver's License Number *

Name (as it appears on passport) *

First

Last

Passport Number *

Issue Date *

Expiration Date *

In case of an emergency, please notify:

Name *

First

Last

Address *

Line 1

Line 2

City

State

Zip Code

Country

Home Phone Number *

Cell Phone Number *

Work Phone Number *

Email *

Medical History:

General Health *

GoodFairPoor

Allergies (food, drugs, other) *

Medical Treatment Received This Past Year *

Limitations/ Accommodations Needed *

Are you willing to improve your health? *

YesMaybeNo

Have you had or been exposed to contagious disease in past 6 months? *

YesNo

If yes, what? *

Medicines Taken & Purpose *

Physician Information:

Name *

First

Last

Address *

Line 1

Line 2

City

State

Zip Code

Country

Office Phone Number *

Email *

Insurance Information:

Name of Insurance Company *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Policy Number *

Beneficiary *

Character Reference/ Ministry Info:

Are you willing to be led by authority of leaders? *

YesNo

Please list three character references from different areas of your life.

Name of Co Worker/ School Authority *

First

Last

Phone Number *

Email *

Name of Ministry Leader *

First

Last

Phone Number *

Email *

Name of Sibling or Close Friend *

First

Last

Phone Number *

Email *

Involvement:

What is the name of your church? *

How long have you been attending? *

Have you been baptized or fellowshipped into the church? *

YesNoUnsure

Are you apart of a small group or bible study? *

YesNo

How are you invested in the life of your church/ community? *

Please indicate any special skills, talents or Christian service experience that would be helpful on this mission trip. *

Please list any previous outreach experience. *

Explain what it means to be a Christian to someone you just met. *

What is the purpose of baptism? *

How is your relationship with Christ being developed? *

How do you know Jesus as your Savior? *

What is the most difficult experience you have ever faced in your life and how did you get through it? *

What is the purpose of missions? *

Share a recent experience of how you look for opportunities to tell others about Christ? *

Testimony:

Please share your testimony. *

What do you believe is the most significant thing the Lord is doing in your life right now? *

What do you believe God is teaching your right now? Be as specific as possible. *

How do you know you're called to participate in this mission trip *

What do you hope to see the Lord do to you through this mission trip? *

What do you know about prayer? Tell me about your prayer life. How comfortable are you with praying aloud? *

How do you worship? Explain your worship outside of church? *

How do you handle conflict? What are you buttons and how you do respond when they are pushed? *

Have you been involved in voluntary sexual relationships outside of marriage? *

YesNo

Have you been dependent upon alcohol, drugs, tobacco products? *

YesNo

Have you had arrest other than minor traffic violations? *

YesNo

Have you been involved in pornography/prostitution? *

YesNo

Is there anything you have been involved in that could hinder your witness? *

YesNo

If you answered yes to any of the above questions, how are you striving in pursuit of holiness now? *

How can your repentance of your past, aid you in working with girls and boys of similar pasts? *

The following question may feel extremely uncomfortable for you but must be answered due to the condition of the girls and boys we will be working with?

Have you ever been emotionally, verbally, physically, sexually abused or neglected? If yes, how have you experienced redemption in these areas of your life? *

How do you feel that your “terror” story can be useful in working with abused or girls at risk of abuse? *